Indu Dubey

Effect of meta-cognitive training in the reduction of positive symptoms in schizophrenia

Metacognitive training (MCT), a variant of Cognitive Behaviour Therapy, is a recently developed therapeutic method that targets active positive symptoms, primarily delusions. It translates basic research related to cognitive biases behind these symptoms into a training procedure for schizophrenia patients. To see the effectiveness of MCT a total of sixteen recently admitted schizophrenia patients were randomly divided into two groups. One group underwent treatment as usual (TAU) and the other group underwent MCT plus TAU. The MCT group showed steeper decline in positive symptoms with medium to large effect sizes. Findings are discussed in the light of their practical implications.

Long-term concentrative meditation and cognitive performance among older adults.

ABSTRACT Background: The general consensus that cognitive abilities decline with advancing age is supported by several studies that have reported that older adults perform more poorly on multiple tests of cognitive performance as compared to younger adults. To date, preventive measures against this cognitive decline have been mainly focused on dietary, physical, and lifestyle behaviors which could allow older adults to maintain their cognitive abilities into late life. However, much less stress has been laid on evaluating meditation as a preventive measure in such cases in spite of the fact that the role of meditation on attention has been proved in several studies. In the current study, we extend this preliminary idea, examining the practice of concentrative meditation and the differences in the cognitive performance of older adults who have or have not employed this practice long term. Methodology: This was a cross-sectional study comparing the cognitive performance of meditators and non-meditators in the geriatric age group. Twenty (age > 55 years) long-term practitioners of Vihangam Yoga meditation (>10 years of practice) were recruited in the present study and were applied six paper–pencil neuropsychological tests for assessment of short-term memory, perceptual speed, attention, and executive functioning. The tests used were: (1) the Digit Span test, (2) the Stroop Color Word test, (3) the Trailmaking test, (4) the Letter Cancellation Task, (5) the digit symbol substitution test, and (6) the Rule Shift Card Test. All the tests were also applied to 20 age- and education-matched geriatric adults who have not practiced the meditation technique. Results: Vihangam Yogis showed significantly better performances in all these tests of attention (p < .05) except for the digit backward test, where a trend (p = .08) was found in favor of meditators. Conclusion: Long-term Vihangam Yoga meditators have superior cognitive abilities than non-meditators in the old age group. This technique should be studied further for its ability to prevent age-related cognitive decline.

LONG-TERM VIHANGAM YOGA MEDITATION AND SCORES ON TESTS OF ATTENTION

Although the literature indicates that meditation has beneficial effects on several aspects of human functioning, few studies have specifically investigated the effects of meditation on various domains of attention. This study was conducted to examine the differences in various domains of attention between long-term concentrative meditators versus matched controls. 15 practitioners of Vihangam Yoga (> 10 yr. experience) were enrolled in the study. Controls matched on age, sex, and years of education were recruited. Both groups were administered the Stroop, Trail-Making, and Digit Symbol Substitution tests as well as the Digit Forward and Digit Backward tests. The group of Vihangam Yogis had significantly better mean performance on all tests of attention. Long-term Vihangam Yoga meditation improves attention span, processing speed, attention alternation ability, and performance in interference tests.

Measuring the value of social engagement in adults with and without autism.

BackgroundDifferences in social communication are commonly reported in autism spectrum condition (ASC). A recent theory attributes this to a reduced motivation to engage with others, that is, deficits in social motivation. However, there are currently few simple, direct, behavioural ways to test this claim. This study uses a new behavioural measure of social motivation to test if preferences for direct gaze and face stimuli are linked to autistic traits or an ASC diagnosis. Our novel choose-a-movie (CAM) paradigm measures the effort participants invest to see particular stimuli. This aspect of social motivation is also known as social seeking.MethodsIn experiment 1, 80 typical adults completed the CAM task and a measure of autistic traits. In experiment 2, 30 adults with ASC and 24 age/IQ-matched typical adults completed the CAM paradigm.ResultsThe results from study one showed that typical adults prefer social stimuli over non-social, but this preference is weaker in those with higher levels of autistic traits. In study two, adults with ASC showed a significant reduction in their preference for direct gaze but little difference in their preference for faces without direct gaze.ConclusionsThese data show that social motivation can be measured in a simple, direct, behavioural paradigm. Furthermore, adults with ASC prefer direct gaze less than typical adults but may not avoid faces without direct gaze. This data advance our understanding of how social motivation may differ between those with and without autism.

Beginning steps in school mental health in India: a teacher workshop

As emphasised by this journal, school mental health (SMH) programmes and services, when done well, lead to valued outcomes for students and systems focused on children and adolescents. However, SMH is nearly non-existent in India. Acute scarcity of trained manpower is the main stumbling block. It is therefore imperative to facilitate the process of SMH with some alternative measures, and one way is to enable the primary stakeholders. Towards this end, at the Central Institute of Psychiatry, Ranchi, India a workshop for teachers was conducted which focused on various aspects of SMH. The effectiveness of the workshop was assessed with the help of pre-post and five-month follow-up assessments which showed increased understanding by teachers of psychological problems in children from participation in the workshop. Admittedly, this is a very early step, but we hope that our experiences will be helpful in moving SMH forward in developing nations.

Brief report: a comparison of the preference for viewing social and non-social movies in typical and autistic adolescents

The recently proposed Social Motivation theory (Chevallier et al., Trends in cognitive sciences 16(4):231–239, 2012) suggests that social difficulties in Autism Spectrum Condition (ASC) might be caused by a difference in the motivation to engage with other people. Here we compared adolescents with (N = 31) and without (N = 37) ASC on the Choose-a-Movie paradigm that measures the social seeking. The results showed a preference for viewing objects over smiling faces in ASC, which is in line with the theory of low social motivation. However, typical adolescents did not show any stimuli preferences, raising questions about developmental changes in social motivation. Age was found to play a significant role in moderating the choice behaviour of the participants. We discuss the implications of these findings in detail.

Socio-emotional factors in alcohol dependence

Background: Alcohol-dependent patients are traditionally believed to have insecure attachment styles, higher anger expression, and lower self-esteem. There is a need to study them together. Aim: To understand the relationships amongst various of the socio-emotional factors. Materials and Methods: Forty male patients with Alcohol dependence syndrome and 40 matched healthy controls (General Health Questionnaire-12 score <3) were compared on attachment styles (on Relationship Scale Questionnaire), anger domains (on State Trait Anger Expression Inventory), and self-esteem (on Rosenberg Self-esteem Scale). Statistics and Analysis: Comparison using independent samples t test and chi square test; correlation using Pearsons correlation coefficient. Results: Patients had significantly higher anger expression, ‘anger in’ and ‘anger out,’ and lower self-esteem than healthy controls. Severity of alcohol dependence had significant correlation with ‘anger out,’ and self-esteem had significant negative correlation with anger expression. Conclusion: The present study suggests that the socio-emotional factors studied are developmentally linked to each other.

Bipolar Disorder and Tuberous Sclerosis Complex: Is It A Mere Coincidence?

Tuberous sclerosis complex (TSC) is associated with significant psychiatric comorbidity mainly in the form of autistic disorders, hyperkinetic disorders, depression, and anxiety disorders. There are very few reports of bipolar disorder in TSC. The authors present the case of a patient with TSC having bipolar disorder manifesting as manic as well as depressive episodes. The diagnosis of TSC was based on the presence of facial angiofibromas, enamel pits, and shagreen patches on clinical examination, and the presence of cortical tubers and calcified subependymal nodules on neuroimaging. The patient presented during the manic phase of the illness and responded well to treatment with carbamazepine and haloperidol and became symptom free within 1 month. The patients neuropsychological assessment revealed a borderline level of intellectual functioning and deficits in attention and concentration, recent memory, delayed and immediate recall, and visual retention. To our knowledge, this is the first report of TSC with bipolar disorder having both manic as well as depressive episodes. The nature of association between TSC and bipolar disorder, and its clinical implications are discussed.

Social seeking declines in young adolescents

The desire to engage with others is an important motivational force throughout our lifespan. It is known that social behaviour and preferences change from childhood to adulthood, but whether this change is linked with any changes in social motivation is not known. We evaluated 255 typically developing participants from ages 4–20 years on a behavioural paradigm ‘Choose a Movie’ (CAM). On every trial, participants had a choice between viewing social or non-social movies presented with different levels of effort (key presses/screen touch required). Hence, participants chose not only the movie they would watch but also how much effort they would make. The difference between the effort levels of the chosen and not chosen stimuli helps in quantifying the motivation to seek it. This task could be used with all the age groups with minimal adaptations, allowing comparison between the groups. Results showed that children (4–8 years), older adolescents (12–16 years) and young adults (17–20 years) made more effort to look at social movies. Counterintuitively, this preference was not seen in young adolescents (around 9–12 years), giving a U-shaped developmental trajectory over the population. We present the first evidence for non-monotonic developmental change in social motivation in typical participants.